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Foster Care

Importance, impact of emotional and other issues, role, foster carer perceptions, adoption breakdown, leaving foster care, self-care for social workers, practice approach


Three sections follow:

  1. Background Material that provides the context for the topic

  2. Suggestions for Practice

  3. A list of References

Feedback welcome!


Background Material


Introduction

Foster care social workers have an important role in arranging foster care for vulnerable children.  They are responsible for placing children in appropriate care and ensuring that they are safe and well-treated while in foster care.  In addition, foster care social workers can help prevent children being placed into foster care by offering appropriate support to families and can also play a part in reunifying children with their birth parents (VCU, 2022).


The importance of foster care

Most children who are in foster care have experienced traumatic events such as neglect, substance misuse by their parent(s), physical abuse, sexual abuse, abandonment and homelessness.  Overall, their parent(s) have been unable to provide appropriate care.  This impacts on the child’s ability to reach developmental milestones, perform appropriately in school and build healthy social relationships.  While foster care cannot bring about a quick solution to a child’s needs, it can offer children a relatively safe environment, an environment that may increase the probability that a child will overcome developmental and functional delays brought about through early life neglect and abuse (VCU, 2022)


Emotional issues in children in foster care

Numerous studies have found the foster children have higher rates of mental health concerns and behaviour problems than children in the general population, caused by the traumatic events that led to children being placed into foster care.  These mental health issues can manifest in external behaviour: aggression, unwillingness to conform to rules, stealing, destroying property, hyperactivity and inability to focus.  Foster care children may also internalise their feelings, which can present as anxiety, social withdrawal, fear, depression and somatic complaints such as headaches, stomach pains or weakness.  These challenges can result in poor school performance, early drop-out from school, and difficulty in building enduring relationships between foster children and their foster family (VCU, 2022).


The role of a foster care social worker

The role of the foster care social worker in general terms encompasses:

  • Screening and training foster families,

  • Matching children with foster families or relative caregivers capable of meeting their needs,

  • Evaluating ongoing foster care placements,

  • Supporting foster parents and children in foster care,  and

  • Finding long-term solutions for children through family reunification or adoption (VCU, 2022).


Putting this another way, the necessary elements of the foster care social worker’s role are:

•       Providing information, advice and guidance,

•       Reviewing practical and emotional support needs,

•       Checking standards of care,

•       Responding to comments, concerns and allegations,

•       Ensuring compliance with policies and procedures,

•       Noting significant events and changes to the household,

•       Managing risk, health and safety and ensuring safe care,

•       Reviewing implementation of care plans for each child in placement,

•       Monitoring impact of fostering on the household,

•       Responding to carers’ feedback and concerns,

•       Identifying and supporting learning and development needs,

•       Reviewing current and future use of resources,

•       Checking payments and equipment, and

•       Reviewing records and reviewing carer’s relationship with children placed (Brown et al., 2014).


Featherstone et al. (2018) asked 105 social workers for feedback on their role in the adoption process.  Their research highlighted several issues that social workers felt impacted negatively on their role.

  • Social work’s professional ethics are not routinely and transparently used to inform adoption practice.

  • A human rights discourse in social work in relation to adoption is under-developed.

  • Austerity (e.g. cuts to family support and social work services) is negatively affecting social workers’ role in adoption.  There should be a better balance between support and assessment, with families currently too often subject to repeated assessments rather than being helped.

  • There is too little time available at every stage of the process resulting in less time to work with children and families.

  • Adoptive parents can change plans post adoption and this can be a concern for social workers.  

  • More resources are needed post adoption.

  • The high turnover of social workers means it can be difficult to maintain continuity.

  • Fragmented roles can mean fragmented approaches to families.  Birth and adoptive families usually must deal with many different social workers at different stages of the process.


Foster carers perception of foster care social workers

Foster carers value both the emotional and practical support (e.g. reliability an availability) provided by foster care social workers, with emotional support often valued over practical support.  Both direct contact and contact by other means is valued, although too much telephone contact can be problematic for the carers.  Specific areas where foster carers appreciate support are managing contact with the foster child’s birth family, during any crises that may arise with the foster child and providing respite for the carer (Brown et al., 2014).


In practical terms foster carers consider good social workers:

•       show an interest in how carers are managing,

•       are easy to contact and responsive when contacted,

•       do what they say they are going to do,

•       are prepared to listen and offer encouragement,

•       take account of the family’s needs and circumstances,

•       keep them informed and included in planning,

•       ensure that payments, complaints, etc. are processed as soon as possible,

•       attend to the child’s interests and needs, and

•       involve foster carers in this where appropriate (Brown et al., 2014)


Factors in adoption breakdown

Adoption breakdown refers to various situations where children placed in families with an intent to adopt exit the family either before or prematurely after the completion of the legal adoption procedures.  Three factors can underpin adoption breakdown: child related factors, parent related factors and support and service factors (Palacios et al., 2019).


Child related factors        An older age at placement is associated with adoption breakdown due to the adverse circumstances an older child may have experienced, as opposed to a younger child.  Persistent maltreatment alters stress reactivity, brain functions, development and behaviour.  The children involved tend to develop a view of the world and people as dangerous and unpredictable, with negative consequences for mood and behavior, as well as for self-regulation and interpersonal relationship capacities.  The average time between placement and breakdown is around five years.  It happens after several years of stress and difficulties.


The child’s emotional and behavioural problems contribute to adoption breakdown, often starting at puberty.  Difficulties include anger, aggression, violence within the adoptive home (often from child to parent), oppositional behavior and running away, criminal offences and sexualized behaviors.  Attachment issues are often identified as contributing to breakdown.  Children with more moves in care are also more likely to experience adoption breakdown.  Removing one child and leaving the others with their parent(s) does result in a higher adoption breakdown rate.


Parent related factors    Research findings concerning adoptive parents’ characteristics associated with breakdown are inconsistent.  However, some themes have emerged.  Parents who successfully manage the problems leading to breakdown have more stability in their marriages (e.g., longer marriages), realistic expectations (unrealistic expectations typically involve idealized views of the child or their own abilities as parents), more flexibility, more experience in parenting special needs children, greater commitment to the child and more willingness to seek help when needed.


Support and service factors          Pre- and post-placement professional activities around adoption make a difference to the likelihood of adoption breakdown.  Suitability assessment, preparation of both parents and children, matching, sharing and explaining information about the to-be-placed children are the main pre-placement professional activities involved.  Parent-child matching has received attention from research, demonstrating that “stretching” parents’ initial preferences to accommodate characteristics of children that otherwise would have no available family may create serious long-term difficulties.  Studies also emphasise the importance of sharing and explaining information about the child to prospective parents.

Aspects of the post-placement professional intervention related to breakdown include the early identification of problems and the support provided to ameliorate them.  Early detection is of critical importance.  Without it, unresolved conflicts mount and becomes more difficult to manage.  Limited identification can be caused by parents being unwilling to contact a service because of not being fully aware of problems, being worried about being blamed, or thinking that seeking help means failure.  The fragmentation of responsibilities is a major issue behind mobilisation difficulties.  Unfortunately, post-adoption services are often only provided in months following placement whereas many adoptive parents do not need and seek support for years.


Leaving foster care

Several reviews and studies have reported poor outcomes for those leaving care.  This appears to be a worldwide phenomenon.

  • At ages 17 and 18, youth in foster care are between two and four times more likely to suffer from mental health disorders than non-placed young people, and they are much more likely to use mental health services and substance treatments compared to the general population of the same age.  

  • At the end of foster care, one fifth of care leavers are not provided with health care services for to their needs.

  • Half of looked-after young people suffer from severe behavioral and emotional problems and almost half are affected by delayed development.

  • In adulthood, 22% have a history of drug abuse and between 37% and 50% have serious criminal activity in their records, in comparison with only a few per cent in a control group consisting of members of the general public.

  • Girls placed in foster care due to behavioral problems are 30 times more likely to have been hospitalized in adulthood for mental health problems in comparison with girls in the general population.

  • Of boys placed in foster care due to behavioral problems, 5% had died before the age of 25, every second had been in prison and almost every third had been hospitalized for mental health problems.

  • Lack of education hinders care leavers’ possibilities of employment. Half of care leavers with no formal qualifications were unemployed several months after leaving care.

  • Studies have also shown a high correlation between foster care and later homelessness. Almost half of the young people with a care history were in temporary housing or staying with family/friends during the first years following foster care (Haggman-Laitila et al., 2018).


A recent review of literature (Haggman-Laitila et al., 2018) suggested that young people approached the transition from care with either a positive or negative approach.


Young people who were positive about their transition from care had confidence in their capabilities to be able to build new life.  They were confident of establishing a communication network with their biological family, friends, employers, teachers, government officials and even with complete strangers. They engaged in studying, found accommodation, and had advanced skills in using the internet and perusing advertisements in newspapers.  For some, self-confidence was strongly grounded in hope that things would get better.  For others, self-confidence was based on a never-give-up attitude and resilience learned through challenges faced previously in life. These care leavers continued to make efforts regardless of the challenges they encountered.


Young people who were negative about their transition  from care often had no parental figures or support person to provide any suggestions and advice.  Care leavers were discouraged by fears of losing their peers and supportive adults who had helped them in aftercare, and anticipated encountering social isolation and a possibility of loneliness and homelessness.  They felt insecure about their future, and felt vulnerable to people taking advantage of them financially, occupationally and sexually.


There is a need for the provision of purposefully planned transition services, which include individualized transition plans and family involvement.  Attention to any issues with the foster care leaver’s birth family should be addressed.  Young people who had been prepared for their transition to independent living by specific programs emphasized the importance of helping young people become independent before leaving care. Preparation is particularly needed on managing money, housing, transportation and self-care issues, improving work and study habits and problem-solving skills in social situations.  Care leavers are often left mostly alone in managing challenges related to educational qualifications, accommodation, employment, financial situation, daily living skills, building relationships and assimilating to cultural norms and using health services.  Keeping in touch with foster care leavers after care concludes would be a positive step to address some of the issues (Haggman-Laitila et al., 2018).


Self-care for foster care social workers

Foster care social workers report that while they find their jobs greatly rewarding, their role comes with high levels of stress and can be emotionally overwhelming. As witnesses to family turmoil, cases of abuse and stories of trauma, foster care social workers often experience secondary trauma, i.e. emotional duress when hearing about and addressing the traumatic experiences of others.  Therefore, foster care social workers must prioritize self-care. The following strategies can safeguard the well-being of foster care social workers and prevent burnout.

  • Pay Attention to Physical Health.

  • Set Boundaries Between Work and Personal Time.

  • Adopt Mindfulness Practices.

  • Take Mini-Breaks Throughout the Day (VCU, 2022).


Suggestions for Practice


The literature suggests five roles for social workers in foster care: (i) working towards permanency, (ii) placing children in supportive homes, (iii) providing ongoing support to foster families, (iv) managing the transition from foster care to independent living, and (v) addressing issues around social work conditions in organisations.


1.  Working towards permanency

Foster care social workers develop permanency plans for families. These plans outline a path toward giving children permanent, safe living situations that support their well-being through family reunification, adoption or long-term foster care.


The development and realization of permanency plans usually involves working with a child’s natural caregivers to create a roadmap for reunification. Foster care social workers discuss the reasons for a child’s removal with natural caregivers and develop strategies to alleviate the circumstances that led to the removal. They set goals to help natural caregivers reach a point at which they can:

  • Keep their children safe from abuse and neglect

  • Meet their children’s need for emotional support, food, medical care, etc.

  • Demonstrate a commitment to improving their parenting skills


This often involves the natural caregiver’s participation in programs that help resolve drug and alcohol misuse and family violence. Foster care social workers connect natural caregivers to services that address issues such as:

  • Anger management

  • Parenting skills

  • Building resilient family bonds

Permanency plans may also require natural caregivers to participate in substance use testing, therapy and sexual abuse counselling.


During the separation of children and their natural caregivers, foster care social workers arrange for regular visits between them, and they keep natural caregivers informed about their children’s progress and health. Foster care social workers also monitor natural caregivers’ progress in achieving plan goals (VCU, 2022).


2.  Placing children in supportive foster homes

Foster care social workers need to find stable and safe environments for the children placed under their charge. Finding related caregivers often offers children an easier transition than placing them with people they don’t know.  

If no one familiar to the child can take on caregiving responsibility, foster care social workers locate appropriate foster families. Finding a stable and lasting placement can mean:

  • Less trauma to the foster child, so fewer behavioral and emotional problems.

  • Better opportunities for the foster child to build healthy attachments with adult caregivers.

  • More continuity in the foster child’s schooling, medical care, therapy and relationships.

Social workers conduct interviews and home studies to measure the fitness of prospective foster parents and ensure their home environment meets safety, health and state requirements.  They seek compassionate foster parents who already share stable nurturing relationships with family members. Foster care social workers also search for foster parents open to learning new skills and methods for positive discipline and who want to share a loving safe home with a child who needs one (VCU, 2022).


Foster care social workers look for a family that fits the needs and personality of the individual young person, as well as allows for continuity of relationships prior to placement (with peers, community, spaces of belonging).  They provide foster families with information about the foster children.  Foster care social workers also facilitate a sustainable relationship with the birth family, always referring to the birth family in a respectful manner (Fylkesnes et al., 2021).


3.  Provide ongoing support to foster children and families

a.  Supporting foster children

In 2021 Fylkesnes et al. asked 209 young people to identify what adults (foster carers and foster care social workers) did that provided appropriate help and support to them.  Three themes emerged.


1. Enable participation      ‘Enable participation’, refers to the value of enabling young people’s participation in everyday life and decision-making processes, that is:

  • Take our perspective—adults were urged to ask young people what they think and feel about their situation, as well as convey to the young person that his/her views are important.

  • Make our views matter—this category involves genuinely believing that the young person has something important to say and trusting that the young person tells the truth; areas include house rules, placement options, appropriate help measures and contact with birth family.

  • Let us decide—sometimes let young people decide for themselves.


2. Build trusting relationships         This theme involves laying the ground for a mutual trusting relationship through:

  • Being available—developing trust depends on adults’ availability, through regular meetings, timely responses to requests, ensuring continuity in relationships as well as accommodating meeting places where the young person could feel safe/encouraged to share information.  The importance of availability was further underscored by participants describing how unpredictability in contact and shifting relationships with social workers and supervision officers might lead to feelings of powerlessness and distrust.

  • Being honest—building trust was linked to adults’ willingness to openly share information with the young person.

  • Being kind and humourous—using warmth and laughter makes young people feel at ease in the adult’s presence.


3. Provide appropriate follow-up   This theme entailed the kinds of support young people in foster care may need from adults:

  • Care for us—providing young people with the love, understanding, emotional and practical support they need to thrive (e.g. school and homework, health issues, practical needs, economic help (allowance) as well as activities and relationships with friends).

  • Fit follow-up to individual needs—identify and address the hardships and hassles the individual young person experiences through engaging with young people and adults.

  • Monitor and follow-up the foster home—monitor how the child is doing in the foster home and be observant of the possibility that the child might not get the care s/he needs in the foster home.  Consider individual needs of the young person and placement stability.  Part of appropriate follow-up also involves listening to and trusting the foster parents, thus placing the foster parents more clearly in the role as the primary carers for the young person.


b.  Supporting foster parents and families

Children in foster care need ongoing support, as do their foster parents. Foster care social workers play a key role in helping foster parents provide safe and therapeutic homes to the children in their care.  In regular visits to foster family homes, social workers assess the psychological and physical needs of children and give support to foster parents. Since most foster children have experienced trauma, they often have special needs that require attention (VCU, 2022).


Previous mistreatment often makes it difficult for foster children to form trusting relationships with adults. They then behave in ways that push foster parents away. For instance, they may lie, show physical aggression or refuse to cooperate. Foster care social workers help foster parents better understand and respond to such behavior.  Foster care social workers may recommend therapeutic interventions for the parents, such as Attachment and Biobehavioral Catch-up (ABC—see the Dozier & Bernard (2017) reference below).  ABC helps foster parents reinterpret a child’s disruptive behaviors and respond with nurturing care instead of anger.  This might involve offering encouraging or consoling words, as well as physical affection or comfort.  Additionally, foster care social workers may counsel foster parents on parenting strategies and provide information about foster parent support groups and mentor programs. They may also give them referrals for child therapists, local day care centres, pediatric dentists and other resources, as needed (VCU, 2022).


Palacios et al. (2019) outline how supporting adoptive families can be how complex.  Support can involve: family and child assessment, birth parents’ involvement, sharing information with families, involving youth in their placements, placing children with families, post placement services to facilitate adjustment and deal with attachment issues, and support services once the adoption has been legalized. Other relevant “basics” to consider include: preparation of both parents and children, advocacy and liaison roles with the health and education systems, and supporting the adoptees’ search for their origins.  The diversity and complexity of the tasks and skill required to fulfill the above tasks makes teamwork and specialisation inevitable.


Brown et al. (2014) point out that foster carers want to be part of the ‘team’, the group of professionals responsible for the care, decision making and planning for a foster child.  This should impact on how the supervising social worker conceptualises, as well as actualises, their work with foster carers.  There are a number of key areas that impact on how social workers relate to foster carers:

  • Planning and decision making          Foster parents are more likely to be willing to handle more frustration in dealing with difficult children if they feel integrated as part of the child welfare team.

  • Timing and arrangement of meetings             Foster carers should be consulted about the timing and location of meetings.

  • Foster carer as client or colleague  This can be a source of tension and requires thoughtful handling by the social worker.

  • Joint training        Joint training for foster carers and supervising social workers, as well as with children’s social workers, can be important to signify partnership working

  • Trust       Foster carers can feel they are not sufficiently trusted, and this can affect how they engage as colleagues.

  • Being valued and respected                This is central for effective planning and decision making.

  • Information about the foster child                    Withholding information about the child from foster carers contributes to the feeling of not being trusted.  A key role for the supervising social worker is to ‘broker’ information about the child, helping the carer understand and interpret the information.

  • Communication   The quality of interpersonal communication between the foster carer and their supervising social worker is a critical aspect of the effectiveness of how they work together.

  • Supervising social worker’s familiarity, and work with the foster child                   To meet the child’s needs the social worker should engage with the foster child and the foster carer, particularly when the child’s behaviour is seen as problematic by the foster carer.


4.  Manage the transition from foster care to independent living

Haggman-Laitala et al. (2018) conducted a systematic review of the transition from foster care to adult life.  They reported that several reviews and studies report poor outcomes for care leavers, something that is worldwide.  Three recommendations conclude their review:

  1. Care leavers need holistic and carefully planned support for their independent living that covers all of the important life domains and pays sufficient attention to the issues concerning the care leaver’s birth family.  Multi-disciplinary collaboration should support care leavers in attaining education qualifications, finding accommodation, employment, developing financial (money) skills, daily living skills, building relationships and access to health services.

  2. Care leavers should be involved in the planning and decision-making process prior to children leaving foster care.

  3. It is important to transition smoothly from trustful relationships of care to living independently; keeping in touch after care finishes should be considered.

This topic is covered in more detail in the “Out-of-Home Care” topic outlined elsewhere on this website.  Access OOHC via the home/contents tabs.


5.  Addressing issues in social work organisations

In 2016 the British Association of Social Workers commissioned an enquiry into the role of the social worker in adoption.  As part of this enquire the BASW asked social workers for their view of the role.  Featherstone et al. (2018) summarised the response: 

  • Austerity (e.g. cuts to family support and social work services) is negatively affecting social workers’ role in adoption.  There should be a better balance between support and assessment, with families currently too often subject to repeated assessments rather than actually helped.

  • There is too little time at every stage of the process.  There is less time to work with children and families.

  • Adoptive parents can change plans post adoption and this can be a concern for social workers.  

  • More resources are needed post adoption.

  • The high turnover of social workers means it can be difficult to maintain continuity.

  • Fragmented roles can mean fragmented approaches to families.  Birth and adoptive families usually have to deal with many different social workers at different stages of the process.

These issues present challenges for social workers to advocate for a better outcome for the families they support and the workers themselves.


References

(available on request)


Brown, H. C., Sebba, J., & Luke, N.  (2014). The role of the supervising social worker in foster carehttps://www.education.ox.ac.uk/the-role-of-the-supervising-social-worker/


Dosier, M., & Bernard, K. (2017). Attachment and biobehavioural catch-up: Addressing the needs of infants and toddlers exposed to indadequate or problematic caregiving.  Current Opinion in Psychology, 15, 111-117.  doi: 10.1016/j.copsyc.2017.03.003


Featherstone, B., Gupta,  A., & Mills,  S.  (2018).  The role of the social worker in adoption – ethics and human rights: An Enquiry. British Association of Social Workers.   https://new.basw.co.uk/policy-and-practice/resources/role-social-worker-adoption-ethics-and-human-rights-enquiry 


Fylkesnes, M., Larsen, M., Havnen, K., Christiansen, O., & Lehmann, S.  (2021). Listening to advice from young people in foster care—From participation to belonging.  British Journal of Social Work, 51, 1983-2000.  doi: 10.1093/bjsw/bcab138


Haggman-Laitila, A., Salokekkila, P., & Karki, S. (2018). Transition to adult life of young People leaving foster care: A qualitative systematic review.  Children and Youth Services Review, 95, 134-143.  https://doi.org/10.1016/j.childyouth.2018.08.017


Palacios, J., Rolock, N., Selwyn, J., & Barbosa-Ducharne, M. (2019). Adoption breakdown: Concept, research, and implications. Research on Social Work Practice, 29(2), 130–142. https://doi.org/10.1177/1049731518783852


VCU: Virginia Commonwealth University. (2022). The role of foster care social workers in promoting child welfarehttps://onlinesocialwork.vcu.edu/blog/foster-care-social-worker/

 

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